Editor’s Note: In 2009, shortly after marrying her (first and only) husband, Paolo, Elizabeth Heath was diagnosed with premature menopause and resulting infertility. Paolo and Liz are now parents to a baby girl, Naomi. In this series, Liz recounts the couple’s struggle with infertility, and how they finally achieved a successful pregnancy and parenthood.
In March 2011—when it was time to return to Spain for our second try at embryo transfer—Paolo was unable to accompany me. He was in the middle of a big job, and taking a few days off midweek was just out of the question for him. So his cousin Diana, a nurse, agreed to come along. It would be her first time flying, ever.
As one might expect, comedy ensued. I’d never traveled with a first-time flyer and it’s been several decades since my first flight, so I underestimated how new everything would be to her. She brought huge bottles of lotions and hair care products in her carry-on bag, all of which got dumped at the security checkpoint. She tried to exit through a set of emergency doors in the airport, so she could sneak outside and take a few drags of a cigarette. She also tried to light up on the tarmac when we changed planes in Barcelona. She laughed and squeezed my hand and even cried a little at take-off and landing. But in all, she loved every minute of the experience, and she was good and helpful company for me.
At the clinic, we learned that of the three eggs that had fertilized, two excellent blastocysts remained. As we waited in the lobby to be called in, I closed my eyes and sat with my palms open and facing upwards, and tried to visualize something positive. The face of a baby girl appeared in my mind, with dark hair and eyes, and long eyelashes. I saw the face of a second baby, a boy with lighter coloring, but his image never came into clear focus the way the girl’s did.
The embryologist reconfirmed that our blastocysts were of highest quality: “We can’t make them better than this,” he said, and transfer went off without a hitch. Salomé from the clinic drove us back to the hotel, and I rested for the afternoon while Diana went out and explored Alicante.
Back at home in Italy, I was under strict orders from Paolo and his mother, Franca, to take it easy. No problem. I napped, read, and cruised the Internet looking for any websites that would tell me that anything I was experiencing—a twinge in my abdomen, gas, hiccups, split ends—might mean that I was pregnant. I stayed glued to the Fertility Friends online forum; several of us who’d had negative cycles the previous autumn were all trying again at about the same time. We were all on the TWW, the “Two-Week Wait”—that period after embryo transfer when women and couples just have to cool their heels and wait to take a pregnancy test.
Once one or more blastocysts have been transferred to a woman’s uterus, within a couple of days, they will do one of a few things. They may do nothing, which means they cease to develop and get reabsorbed by her body. They may hatch—hatching is basically the embryo “blasting” out of its protective shell—and then do one of two things: They may do nothing, and again, get resorbed. Or, they may burrow into the uterine lining, where they will either develop or not. An embryo that successfully takes hold in the uterine lining will, within about a week, cause the body to produce trace elements of hCG, the pregnancy hormone. As the embryo grows, more and more hCG is produced. Accepted wisdom is that it takes about 14 days for enough hCG to be present to show up on a urine or blood pregnancy test, hence the TWW.
So it was too early for me to take a pregnancy test, even though it was killing me not to. One evening, less than a week after I’d had the embryos transferred, I sat reading posts on Fertility Friends. Two of my online compatriots had tested, and they both got BFPs (Big Fat Positives)!
I couldn’t stand it any longer. I had already bought a home pregnancy test (I mean, of course I had!) and I told Paolo I was going to use it. “Liz, you’re crazy! It’s too soon!” he said. He was right, of course. My timing was all wrong in a number of ways. Home pregnancy tests should be done first thing in the morning upon waking, when one’s bladder is full and the urine is concentrated. Testing later in the day with less concentrated urine can result in a false negative.
It was around 9pm, six days after the embryos had been transferred. I should have at least waited until the next morning, but I didn’t have the willpower. I went to the bathroom, did the test, and waited a minute or so as the single line showed up on the result window. Not pregnant.
Okay, we said. It’s too soon to jump to any conclusions. I set the test on my desk and went about cleaning up our supper dishes. But something made me go back and look again at the test. A second, fainter than the control line, had appeared. I showed it to Paolo. He was unconvinced. “There’s a line there!” I implored. “Wait a few days and try again,” he said, trying to be the voice of reason and restraint.
I cooled my heels for a few more minutes, and then saw that the line was now darker, almost as dark as the control line. I showed Paolo again. “Liz,” he said, “you’re pregnant for real!”
The next day, I marched into our doctor’s office and got a prescription for an hCG blood test. I went next door to the pharmacy and left some prescriptions to be filled, and quietly asked for a home pregnancy test. I put my finger to my lips to motion to Carmine, our pharmacist, to keep it on the down low. There were three or four other people in line behind me. I know every one of them—remember I live in a tiny Italian town—and at least one of them was a relative of Paolo’s. If anyone caught sight of me buying a pregnancy test, it would be all over town. Carmine slipped the test into a bag under the counter, handed it to me, and patted my hand to wish me luck.
This time, the test was positive, and without ambiguity. When I went back to the pharmacy in the afternoon to get my medication, Carmine looked at me hopefully. I raised my eyebrows in the affirmative, and his face opened in a big grin. So did mine. I was pregnant for real.
I emailed Salomé at the clinic and told her about my two positive urine tests. She emailed back right away, and told me to get the hCG blood test done ASAP. Then, she added, “Congratulations, Mrs. Heath, you are pregnant!”
Diana came the next morning and did a blood draw—one of the many benefits of having a nurse in the family—to take with her to the hospital where she works. Paolo was still sticking to restrained optimism; he didn’t want to believe I was pregnant until we got the blood test done. It would be hours before we got the test results. The test should have shown an hCG level higher than 25 mIU/ml, since even that small amount shows up on a home test. I don’t think I sat still all morning, waiting for my phone to ring. I kept checking to see if I’d somehow missed a call from Diana, even though the phone was always within easy reach.
Paolo came home for lunch and about midway through our meal, the phone rang. It was Diana. My hCG was at 91 mIU/ml, or most definitely pregnant. I hung up, and told Paolo the number. We hugged, and he started to cry, because he finally was ready to admit it: I was pregnant for real.